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A Trip to the Drug Store: Non Prescription Medications That Your Eating Disordered Patient May Be Abusing: IAEDP Symposium 2009 - What You Should Know

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About the Course:

Webinar from the 2009 International Association of Eating Disorders Professionals Symposium.
Note: For this course there is a small additional fee to obtain the webinar. Please see the “Get Course Materials” link in the right sidebar for details.

Many eating disordered patients abuse non prescription substances in an attempt to lose weight. They typically use these drugs in supra therapeutic doses and in potentially toxic combinations. Our purpose is to alert the clinician to this dangerous and potentially lethal practice. We will describe the major categories of OTC drugs of abuse; diet pills, diuretics, laxatives and emetics. We will explain the clinical complications of abuse. We will present representative cases from our practice. We will review the prevalence data from our large multidisciplinary treatment program. Interspersed throughout the presentation we will include board review-type questions for discussion/debate.

Content Outline:
I. Introduction, OTC drugs A. Diagnostic categories B. Prevalence data 1. Literature review 2. EDI statistics C. Comorbidities 1. Polypharmacy 2. Novelty seeking 3. High risk behaviors 4. ETOH 5. Anxiety disorders 6. Axis II diagnoses D. Review questions/discussion
II. Diet pills A. Historic 1. Ephedra 2. Phenylpropanolamine B. “Top Sellers” 1. Hydroxycut 2. Herbalife 3. Dexatrim C. New products 1. Hoodia gordonii 2. Orlistat D. Case history E. Review questions/discussion
III. Diuretics A. Diurex B. Pamprin C. Midol D. Case History E. Review questions/discussion
IV. Laxatives A. Categories and examples 1. Stimulant, Correctol, Ex-lax, etc – most abused 2. Osmotic, Miralax 3. Bulk, Psillium 4. Emollient, Colace B. Acute sequelae 1. Hypokalemia 2. Volume depletion C. Chronic sequelae 1. Cathartic Colon 2. Melanosis coli 3. Rectal prolapse 4. Colectomy D. Withdrawal 1. Hyperaldosteronism 2. Massive reflex edema 3. Body image disturbance E. Addiction model, recitivism F. Case history G. Review questions/discussion
V. Emetics, ipecac A. History B. Toxicity myopathy and cardiomyopathy C. Literature review, reported deaths D. Case history E. Review questions/discussion
VI. Conclusion A. Constantly changing, need for update B. Role of internet C. Role of FDA D. “Always ask”

This course is based on the recorded webinar, A Trip to the Drug Store: Non Prescription Medications That Your Eating Disordered Patient May Be Abusing: IAEDP Symposium 2009 – What You Should Know created by Deborah Mangham, MD and Ann E. Vosti, MD

Course Material Authors

Course Material Authors authored the material only, and were not involved in creating this CE course. They are identified here for your own evaluation of the relevancy of the material this course is based on.

Deborah Mangham, MD
Deborah Mangham, MD is board cerftified in internal medicine and practiced primary care internal medicine before joining the Park Nicollet Methodist Eating Disorders Institute in 2000. She has been the Clinical Practice Director of the inpatient unit and the Clinical Practice Director of the residential program at the Anna Westin House. She is currently the Assistant Medical Director of the Institute. She was given many presentations on various eating disorder topics at both the local and national level (please see CV for details). She has been interviewed on television and in the popular press. She is currently completing a manuscript on ipecac myopathy. Research interests include intestinal bacterial overgrowth in patients with anorexia nervosa.
Ann E. Vosti, MD
Ann Vosti MD is currently the lead physician at the Park Nicollet Methodist Eating Disorders Institute. She has been with the EDI since 2001. Dr. Vosti is board cerftified in Family Medicine and has practiced primary care. She also has BNS and MPH degrees. She has worked as a nurse in telemetry and in eating disorders. She has taught nursing at the College of St. Catherine in St.Paul, MN. Dr. Vosti has extensive public speaking experience both locally and nationally and is the author of a journal article on eating disorders in older women. In her leisure time she enjoys hiking, riding and yoga. She has 2 young adult sons, 2 cats and a dog.

Course Creator

Recommended For:

This course is recommended for health care professionals, especially psychologists, therapists, and counselors who seek to update their research knowledge and competency in treating patients with eating disorders, increase and acquire new skills, learn new intervention strategies, and obtain continuing education credits. It is appropriate for professionals at all levels of knowledge.

Course Objectives:

After taking this course, you should be able to:

  1. Following this presentation, participants will be able to recognize red flags for types of prescription abuse.
  2. Following this presentation, participants will be able to identify a patient in your office who might be suffering from ipecac toxicity.
  3. Following this presentation, participants will be able to recognize what mucomyst has to do with OTC diuretic overdose.


Disclosure of Relevant Financial Relationships

Disclosure of Relevant Financial Relationships

CE Learning Systems, LLC is an independent provider of continuing medical education. CE Learning Systems, LLC has no proprietary or financial interest in medical or healthcare products over which the FDA (USA) or EMA (EU) has regulatory authority.

In accordance with our disclosure policies, CE Learning Systems, LLC is committed to ensuring balance, independence, objectivity, and scientific rigor for all accredited continuing education. These policies include assigning relevance to, and mitigating, all perceived or real conflicts of interest between any individual with control over the content and any ineligible company (commercial interest).

Any individual with control over accredited content, including planner, faculty, and reviewer, is required to globally disclose:

  1. Individual relationship(s) or lack thereof, and its nature, with any/all ineligible company, and
  2. any investigational, off-label, or non-FDA approved content or discussion

CE Learning Systems, LLC has reviewed these disclosures, assigned relevance based on the relationship and scope of content, and identified those with the potential to compromise the goals and educational integrity of the education. Relevant relationships, or lack thereof, are shared with the learner.

Education has been independently peer-reviewed to validate content, mitigate identified conflicts of interest, and ensure:

  1. All recommendations involving clinical medicine is based on evidence that is accepted within the medical profession as adequate justification for their indications and contraindications in the care of patients.
  2. All scientific research referred to, reported, or used in accredited continuing education in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection, and analysis.
  3. Content is appropriate, fair and balanced, unbiased, referenced, and non-promotional.

The planners have reported the following: There are no relevant disclosures.

Course Material Authors

The authors have disclosed any disclosures within the material.

Course Creator: Max Schwanekamp
There are no relevant disclosures.
Commercial support

There is no commercial support for this distance-learning course.

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Course Number 101706
2 CE credit hours
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  • Recorded Webinar
Exam Fee $11.94
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